Carcinoma of lung is classified by histologic cell type, this is based on predominant major cell population by tissue specimen. But in fact a range of 13% to 63% of lung cancer has been appeared to be heterogeneous cell type at the light microscopic level. After treatment of the mixed lung cancer and/or with time there are reports that cell type is changed. Because it is possible that the tumor were pleomorphic and that the antitumor therapy eliminated the more sensitive cell population and permitted the subsequent emergence of the more resistant cell population. The authors reported here, a case of 32 year old female patient with mixed lung cancer composed of three cell type, and this is the first case in Korea.
Adult ; Female ; Humans ; Korea ; Lung ; Lung Neoplasms ; Population Characteristics

No abstract available.
Humans

OBJECTIVES: To investigate the changing pattern of medical utilization claims following the economic crisis in Korea. METHODS: The original data consisted of the claims of the 'Medical insurance program of self-employees' between 1997 and 1998. The data was selected by medical treatment day ranging between 1 January and 30 June. Medical utilizations were calculated each year by the frequency of claims, visit days for outpatients, length of stay for inpatients, total days of medication, and the sum of expenses. RESULTS: The length of stay as an inpatient in 1998 was decreased 4.7 percent in comparison to 1997. However, inpatient expenses in 1998 increased 10.8 percent as compared to 1997. Inpatient hospital claims in 1998 increased 6.2 percent over 1997, although general hospital inpatient claims in 1998 decreased 3.3 percent in comparison to 1997. The outpatient claim frequency decreased 7.3 in 1998 percent as compared to 1997. Outpatient visit days of in 1998 were decreased 8.5 percent in comparison to that recorded in 1997. Outpatient claim frequencies of 'gu region' in 1998 decreased 10.5 percent comparison to that in 1997, but 'city and gun region' decreased less than 'gu region'. CONCLUSIONS: Medical utilization in 1998 deceased in relation to 1997. Medical utilization by outpatients decreased more than that of inpatients. Medical utilization by 'gu regio n' decreased more than the other regions.
Hospitals, General ; Humans ; Inpatients ; Insurance ; Korea* ; Length of Stay ; Outpatients

OBJECTIVES: This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. METHODS: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. RESULTS: In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. CONCLUSIONS: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area.
Adult ; Asian Continental Ancestry Group ; Blood Glucose ; Blood Pressure ; Blood Transfusion ; Body Mass Index ; Case-Control Studies ; Cholesterol ; Coffee ; Cohort Studies ; Glucose ; Humans ; Insurance ; Korea ; Logistic Models ; Mortality* ; Obesity ; Odds Ratio ; Surveys and Questionnaires ; Retrospective Studies ; Risk Factors ; Sex Distribution ; Smoking

PURPOSE: The aim of this study is to investigate the effects of high humidification of nearly 100% on insensible water loss and total fluid requirement in very low birth weight infants during their first week of life. METHODS: We retrospectively compared twenty-five infants (GA 28.1+/-1.7 wk, and BW 970+/-186 g) who were cared for in a double walled incubator with high humidification with 24 infants (GA 27.6+/-2.2 wk, and BW 972+/-186 g) who were in a double walled incubator without raised humidity during the first week of their life. We analyzed the changes in body weight, total fluid intake, insensible water loss, urine output, input of sodium and potassium, serum levels of sodium and potassium, and the incidence of complications during the hospitalization in the high humidified group and the control group. RESULTS: High humidification during the first week of life in very low birth weight infants reduced insensible water loss and total fluid requirement. However the imbalance of serum electrolyte or oliguria did not increase. The high humidification group (n=25) acquired more physiologic weight loss during the first two weeks of life than the control group (n=24) but gained more weight than the control group (n=24) on the third month of life. Infants nursed with high humidification showed an increased tendency toward spontaneous closure of the patent ductus arteriosus and a decreased tendency toward surgical ligation of the patent ductus arteriosus and intraventricular hemorrhage without the evidence of an increase in infection. No significant differences were noted in the incidence of patent ductus arteriosus, bronchopulmonary dysplasia and retinopathy of prematurity. CONCLUSION: The high humidification of nearly 100% and fluid restriction therapy during the first week of life were effective in the fluid and electrolyte management of very low birth weight infants.
Body Weight ; Bronchopulmonary Dysplasia ; Ductus Arteriosus, Patent ; Hemorrhage ; Hospitalization ; Humans ; Humidity ; Incidence ; Incubators ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Ligation ; Oliguria ; Potassium ; Retinopathy of Prematurity ; Retrospective Studies ; Sodium ; Water Loss, Insensible ; Weight Loss

OBJECTIVES: The purpose of this research was to evaluate the ability of completing death certificates among medical students. METHODS: The self-administered questionnaires were completed, during May to August 2007, by 380 medical students in senior. The questionnaire was composed of 10 cases to write the death certificate. The cause-of-deaths written by students were compared with the gold standards and their errors in the certificates also evaluated. RESULTS: Mean agreement score for 10 underlying cause-of-deaths completed on the lowest line of part I in the death certificate (UC1) was 4.8+/-1.7, and for underlying cause-of-death selected by a coder of the death certificates (UC2) was 5.6+/-1.5. The UC1 and UC2 were significantly higher among the students having the case-oriented education for death certificate than others. For the major errors in the certificates completed by students, the students having the error with no antecedent cause were highest, the error with two or more conditions secondly highest. Mean number of errors was significantly lower in the case-oriented education group than others. CONCLUSIONS: Errors are common in the death certificates completed by medical students in senior. The accuracy of death certification may be more improved with the case-oriented education than the traditional method.
Certification ; Death Certificates ; Education, Medical ; Humans ; Students, Medical ; Surveys and Questionnaires

PURPOSE: To investigate and compare the clinical manifestation and prognosis of preterm and full-term infants with Down syndrome (DS). METHODS: We retrospectively reviewed 80 patients diagnosed with DS and confirmed by chromosomal study at the Samsung Medical Center between January 1994 and July 2014. Data on demographic characteristics, associated anomalies, treatment, prognosis and cause of death were compared between preterm and full-term DS infants. RESULTS: Of the 80 confirmed DS patients, there were 49 (61%) full-term and 31 (38%) preterm DS infants. The mean gestational age of full-term DS infants was 38(+1)+/-0(+2) weeks (range, 37(+0)-40(+0) weeks) and the mean birth weight was 3,007+/-418 g (range, 1,930-4,100 g). The mean gestational age of preterm infants was 34(+1)+/-2(+1) weeks (range, 29(+1)-36(+6) weeks) and the mean birth weight was 2,181+/-598 g (range, 890-3,500 g). There were no differences in demographics, associated anomalies, mortality or related factors, or the rate of active treatment between full-term and preterm DS infants. CONCLUSION: In this single center study, the mortality rate of preterm DS infants was comparable to that of full-term DS infants. Larger national cohort studies might be needed to further investigate the prognosis of preterm DS infants.
Birth Weight ; Cause of Death ; Cohort Studies ; Demography ; Down Syndrome* ; Gestational Age ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Mortality ; Prognosis* ; Retrospective Studies

BACKGROUND: Chronic kidney disease is a common complication after liver transplantation. In this study, we analyzed the results of kidney biopsy in liver transplantation recipients with renal impairment. METHODS: Between 1999 and 2012, 544 liver transplants were performed at our hospital. We retrospectively analyzed the clinical and histological data of 10 liver transplantation recipients referred for kidney biopsy. RESULTS: The biopsies were performed at a median of 24.5 months (range, 3-73 months) after liver transplantation. The serum creatinine level was 1.81+/-0.5mg/dL at the time of kidney biopsy. There were no immediate complications. The most common diagnosis was glomerulonephritis (GN), such as immunoglobulin A nephropathy (n=4), mesangial proliferative GN(n=1), focal proliferative GN (n=1), and membranous GN (n=1). Typical calcineurin inhibitor (CNI)-induced nephrotoxicity was detected in three cases (30%).Chronic tissue changes such as glomerulosclerosis, interstitial fibrosis, and tubular atrophy were present in 90%, 80%,and 80% of cases, respectively, and mesangial proliferation was detected in 40%of cases. We began treatment for renal impairment based on the result of kidney biopsy; for example, angiotensin-receptor blockers or steroids were prescribed for GN, and the CNI dose was reduced for CNI nephrotoxicity. As a result, eight of 10 patients showed improvement in glomerular filtration rate, but two progressed to end-stage renal disease. CONCLUSION: Kidney biopsy is a safe and effective method for determining the cause of renal impairment after liver transplantation. Management of patients based on the result of kidney biopsy may improve renal outcomes.
Atrophy ; Biopsy* ; Calcineurin ; Creatinine ; Diagnosis ; Fibrosis ; Glomerular Filtration Rate ; Glomerulonephritis ; Glomerulonephritis, IGA ; Humans ; Kidney Failure, Chronic ; Kidney* ; Liver Transplantation ; Liver* ; Methods ; Renal Insufficiency, Chronic ; Retrospective Studies ; Steroids ; Transplantation*